Majority of patients have ‘long Covid’ symptoms seven weeks after discharge

More than two-thirds of patients hospitalised due to coronavirus (Covid-19) continue to suffer from debilitating symptoms more than seven weeks after being discharged, a new study suggests.

Researchers found that 54 days after discharge, 69% of patients were still experiencing fatigue. And 53% were suffering from persistent breathlessness.

They also found that 34% still had a cough and 15% reported depression.

In addition, 38% of chest radiographs (X-rays) remained abnormal. And 9% were getting worse, according to the study. It was carried out in collaboration with clinicians at the Royal Free London (RFL) and University College London Hospitals NHS Trust (UCLH).

A real phenomenon

Dr Swapna Mandal, an honorary clinical associate professor at UCL division of medicine, said the data shows so-called “long Covid” is a real phenomenon. She added that further research is needed to understand how the symptoms can be treated in the long-term.

She said:

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Patients whose Covid-19 illness is serious enough for them to require hospital care often continue to suffer significant symptoms for many weeks after their discharge.

Professor John Hurst, at UCL division of medicine, said:

Understanding ‘long Covid’ is critical in helping people who have been through this life-changing experience return to health, while rapid roll-out of this follow-up service shows how our clinical teams worked together to deliver an innovative service during a period of unprecedented demand on our staff.

Findings

In the study, published in the medical journal Thorax, clinical teams set up a post-coronavirus follow up clinic. This was to review both the psychological and physiological symptoms of discharged patients.

In total, they observed 384 patients who had tested positive. Patients had been treated at Barnet Hospital, the Royal Free Hospital or UCLH.

Collectively, the average length of stay in hospital was 6.5 days.

All of the patients were spoken to by a member of the clinical team on average 54 days after they’d left hospital.

Some further face-to-face clinical appointments were required for patients needing rehabilitation and/or further investigation.

The research suggests that for those patients whose chest X-ray was still showing signs of infection on being discharged, 62% had a normal x-ray when it was repeated. While the remainder (38%) were still showing changes.

Almost one in ten (9%) of these patients had an X-ray which was worse than when they were discharged.

Limitations

The scientists note a number of limitations to their study. These included that the study only had patients who tested positive for SARS-CoV-2, the virus that causes Covid-19. And patients requiring prolonged ICU and in-patient stay may be under-represented in the analysis.

They add that not all participants were willing to take part in the review or attend for investigations, which potentially introduced selection bias.

The researchers can’t determine if these features are unique to coronavirus. They may simply be similar to those following admission for other critical respiratory illnesses.